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Comment by CGMthrowaway | Hacker News Reader

PSA: If a probiotic is on the shelf, not in a cooler, it's probably not worth buying. The best companies certify the count of organisms at time of manufacture, but no counts are guaranteed at the shelf. Probiotics are living organisms and ought to be refrigerated for max lifespan.

You can get refrigerated probiotic supps at a place like Whole Foods.

Source: I used to work in the industry.

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When I asked my doctor about which kinds of probiotics are most effective she specifically mentioned refrigerated vs non-refrigerated is not a way to identify quality or effectiveness unless you know the specific strain(s) needed cannot be made shelf-stable. This lined up with asking my endodontist after they prescribed some antibiotics for a tooth infection. They did warn that the use by dates are a bit bull, not to stock up on them as they do deteriorate in quality with time, and not to try to keep even the shelf-stable ones above room temperature.

Maybe I misunderstood what my doctor said, maybe my doctor was just wrong, maybe it's actually extremely nuanced, maybe it's something I hadn't even considered. I guess all I'm saying is it's probably better to talk to your doctor(s) about it than follow self-sourced (in both the above and this comment) medical advice from HN.

Also frankly, doctor =/= expert on probiotics.

None of their training really addresses that and while they might be more qualified to read research than random layman I would not in general ascribe authority to what a random practitioner has to say about probiotics. Frankly, the research on probiotics is still very much in its infancy and a LOT remains to be figured out.

> doctor =/= expert on probiotics

Medical microbiologists would love to have a word with you. Medicine and medicine-adjacent disciplines each develop institutional knowledge that percolates from each specialized discipline.

> …the research on probiotics is still very much in its infancy and a LOT remains to be figured out.

I’m curious who you think does the research. It’s certainly not Bubba from down the creek.

PhDs do the research. Not your typical overworked family practitioner.

They don’t develop treatment protocols or testing modalities either. Knowledge gets disseminated as best practices and gets applied as needed to different specialties.

If probiotics is what you’re after, why not eat or drink something fermented?

Absolutely, if you have access to domain specific experts or researchers than that should trump whatever your more generalized expert will say.

Also right to highlight that just because there exist specialist in something does not mean we have the full or correct understanding yet, it's just your best place to find information regarding it unless you want to go join the field.

Great points!

“ and not to try to keep even the shelf-stable ones above room temperature.” - hate to ask, but night brain kicked in - could I trouble you to give me an alternative way of phrasing this? I keep parsing it as “don’t even bother trying to keep probiotics warm”

"Even the ones that can be kept outside a fridge shouldn't be kept above room temperature".

No night brain, just a good splice on my part after editing that sentence down :). stavros has a great rewrite already, but an even more succinct one for just the particular snippet could be:

"even shelf-stable probiotics should not be kept above room temperature".

"room temperature" has a whole lot of variation without even thinking about the extremes of population location. :(

They gave it as a defined term with a pdf copy of https://www.goodrx.com/drugs/medication-basics/which-is-the-... describing the ranges - I just neglected to include all of that detail in my comment :). Another example of why it's great to discuss with your doctor instead of advice from forum comments! Googling around, apparently these values are standardized for pharmacology in the US by the USP, other areas may have other standards.

Hope that helps!

Heh, yeah the "68°F to 77°F" range which that PDF quotes as room temperature (20°C to 25.6°C in proper units) is very much NOT room temperature anywhere near me either. ;)

The last step in the receipt of my first beer batch stated: "now store it at a warm place around 21ºC".

No way I could find a place this cold during Rio de Janeiro summer.

> maybe my doctor was just wrong

Yes, doctors are similar to mechanics or any other trade, in that some simply suck.

Some got Ds.

>self-sourced

It's not "self-sourced" whatever that means (like that's a bad thing per se?). I saw the sausage being made and I spoke to the sausage makers. The source is the sausage makers, not me. Sorry I don't have a link. These facts may or may not be trade secrets.

"Self-sourced" as in both of our comments are hearsay: we say we heard this information from someone and our source for that is only us saying so. That's pretty bad in terms of what others can actually do with that information (from either of our comments). Not just because hearsay can be faked, but more because it's unquestionable, untestable, and the quality of the information has almost always greatly degraded compared to the source.

This doesn't mean the comments should be assumed to be false any more than they should be assumed to be true. It also doesn't imply we necessarily have some way to provide an actual source either. Just that folks will have to go elsewhere if they want any certainty about this information, since we didn't provide any as random usernames on a message board saying we heard something before.

There are some newer types of probiotics (called "spore-based") which claim better shelf stability (don't require refrigeration) and resistance (to populate further down the digestive system). But you're absolutely right, they tend to die off pretty quickly (be extra weary of ordering them online, especially during the summer if they're going to sit around in a hot delivery truck or mailbox!).

That is more around solving a different problem than shelf-stability, which is the fact that most probiotics targeting the intestines don't survive in great measure beyond the stomach.

> The best companies certify the count of organisms at time of manufacture

The best companies certify the viable count at expiration, I've seen many that do.

There is a difference between probiotics in live culture and shelf stable products but both can be viable methods of delivery.

They sell a yogurt starter that is purportedly Salivarius and ruteirii culture over at Beazos' Clubhouse. I haven't had it tested but it's way easier than the usual Bulgarian microbes. Assuming the cultures are as labeled, I have to imagine eating live culture yogurt is more likely to propogate than loszenges made in a factory though.

I've made the L. reuteri "yogurt" from the BioGaia Gastrus tablets from amazon and it works well. First batch is a little watery but after that it pretty much looks like greek yogurt when I use half and half.

The salivarius / ruteiri culture is way more forgiving than that. Makes a firm, tart yogurt even with non fat milk, without having to add powdered milk.

A very naive question: why are "dry and on the shelf" not worth buying, when so many of the food-related microorganisms obviously work fine through such distribution (baking yeasts, various yogurt starters, cheese molds, etc.)?

Yeasts and fungi produce durable spores. But most gut bacteria do not form spores. When they dry out, they die.

Why not run an experiment like this post: take a probiotic capsule, put its contents in a growing medium; after a day or two, sample from the medium and send it in for testing, and see which strains actually grew?

So I shouldn't spend money lactibiane buccodental oral probiotics in pills?

does this apply universally to bacterial strains ?

Yes

The Internet almost universally disagrees, based on a quick search:

https://seed.com/cultured/probiotics-refrigeration-storage-g...

Lyophilization is a fancy word for freeze-drying. "If a probiotic is refrigerated, it doesn’t mean it’s a better quality" is of course true. But nothing that I said is false. If I am getting probiotics from a quality source, I am going to prefer the refrigerated product over the "shelf-stable" one every time.

There's a difference between "choosing one over the other" and the original claim of shelf stabilized probiotics being not worth buying.

On a few occasions when my dog has gotten sick, or needed antibiotics, shelf stabilized probiotics cleaned their digestion right up.

Are strains that only survive when refrigerated probably a higher count? Maybe. Are there stains that are better but can't be freeze dried? Probably. Are there shelf stable probiotics that are worth buying, especially if you don't have access to refrigerated stuff? Absolutely!

I never denied any of that. Read my comment again, more carefully.

The very first line of your comment:

> PSA: If a probiotic is on the shelf, not in a cooler, it's probably not worth buying.

is exactly what I was responding to, along with your one word response "Yes" to that applying equally to all bacterial strains, which is also untrue.

The statements below can all be taken as true, together. Probably doesn't not mean always. https://i.imgur.com/BRNn0rJ.png

  If a probiotic is on the shelf, not in a cooler, it's probably not worth buying
  Strains that only survive when refrigerated are maybe probably a higher count
  There are probably strains that are better but can't be freeze dried
  There are absolutely shelf stable probiotics that are worth buying, especially if you don't have access to refrigerated stuff

Why do you think they’re here, sharing the info with you?

If you could just Google it up, not nearly as interesting to HN.

Thank you

what kind of cooler, near zero or just yogurt level temperatures ?

Freezing has potential to cause damage to the organisms, safer to refrigerate (and consume asap)

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